Chondrosarcoma

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 24, 2016
StartDiseasesChondrosarcoma

Chondrosarcoma or CS is an unusual tumor or cancerous growth affecting bone and cartilage. CS can grow in various areas; however, it is mostly present in longer bones and in the pelvic area. Though chondrosarcoma is more likely to occur in males, the cancer can also occur in females.

Contents

Definition & Facts

Chondrosarcoma is a type of malignant tumor or cancer and is closely identified with bone cancer; it can sometimes spread to nearby tissues. Chondrosarcoma usually grows superficially on bone matter and is classified into two types: primary and secondary. Primary CS is usually evident in children, while secondary CS is apparent in adults ranging in age from 30 to 70; however, the age range most affected are people between the ages 40 to 60. Men are 33% more susceptible to being diagnosed with this type of cancer than women.

Symptoms & Complaints

Symptoms of CS may begin as a pain or dull soreness in the affected area. The pain may graduate from moderately irritating to completely debilitating, causing limping and/or swelling in the affected area. It is likely that the pain may not cease with rest.

CS can also cause extensive periods of pain that may even last for years. Chondrosarcoma can often show symptoms of a lump or a large mass that grows in size. The limb experiencing the symptoms of CS may become hard or difficult to move or bend. This can be due to inflammation of cartilage tissue between any set of bones. In pelvic-based tumors, there may be a change in urinary frequency. In some cases, CS can be completely asymptomatic.

Causes

There is not a direct cause known for chondrosarcoma; however, it is hypothesized that there are certain genetics factors that can cause chondrosarcoma. In addition, there is evidence suggesting that people who have had enchondroma, osteochondroma, or some other bone cancer or complication, have an increased risk of chondrosarcoma.

Radiation exposure can also be a factor. Overexposure to radiation causes fluctuations in the way cells reproduce, causing them to duplicate radically and uncontrollably.

Diagnosis & Tests

A multitude of tests exists in order to determine the likelihood or presence of CS. The most common method of detecting both benign tumors (localized, non-spreading tumors) and malignant tumors (metastasizing tumors, affecting other areas or organ systems) is via X-ray.

An X-ray photo reveals bone and any obstructions within or outlying the bone material. MRI (magnetic resonance imaging) scans are used to detect abnormalities in soft tissues (nerves, fats, or cartilages). If chondrosarcoma has spread or become invasive into cartilage/nerve tissues, then this test will render the problems visible for analysis.

CT/CAT (computerized axial tomography) scans are used to view a variety of different organs, tissues and structures in real-time and then analyze the composition. Nuclear bone scanning is a method of injecting the patient with a radioactive agent, and then scanning the patient for bone anomalies. The radioactive agent bonds with the bones, and provides a gamma camera a clear view of any obstructions, bone abnormalities, or cancers.

An orthopedic surgeon or hematologist may perform what is known as a bone biopsy. This is a surgical procedure, where the local area is numbed and then cut open. A biopsy needle is then twisted into the bone to obtain a small bone sample. The area that was extracted is then microscopically examined to determine whether the bone has cancer.

A few blood tests exist that can be used in order to determine the likelihood of a person having CS. These can test for aspartate aminotransferase (AST – a liver enzyme), calcium (a method of assisting with osteoporosis or porous bone disease) and alkaline phosphatase (an enzyme found in the liver and bone). In all these tests, if the levels are irregularly high, the possibility of having chondrosarcoma is increased.

Treatment and Therapy

Chondrosarcoma is usually removed via surgery – there are two methods of removal: amputation, and limb-saving. In limb amputation surgery, the surgeon removes an appendage (usually not the entire limb), replacing it with a prosthetic extension (a metal/mechanical device operating semi/fully functionally).

In limb-saving surgery, the affected area is opened, the tumor/bone is removed from the area (along with healthy surrounding tissue in order to ensure no cancer regrowth occurs) and then the area is closed up after surgery. In most cases, the bone is replaced by a prosthesis or bone transplant. Cases where high-grade tumors exist may require additional radiation therapy.

After surgery, there will be multiple follow-up appointments set up for the patient to determine how well he/she is functioning with the new treatment. It is also necessary that the surgeon check for possible recurrence of chondrosarcoma to avoid future complications.

Prevention and Prophylaxis

There is no way to prevent chondrosarcoma except to limit exposure to radiation.